Massachusetts is unlike most other states when it comes to the right of auto accident victims to sue for personal injuries. We are one of only 12 no-fault states that require your medical costs to be above a certain amount before you can bring an action against the other driver or vehicle owner. This amount is known as the injury threshold. Understanding how this threshold applies can help you take the correct steps to recover fair and adequate compensation after an accident.
The state insurance law provides that an accident victim may not seek damages for pain and suffering unless their medical expenses stemming from the accident are in excess of $2,000. If the expenses are below that amount, then the victim must submit a claim to their own insurance company. These smaller claims will fall under Personal Injury Protection (PIP) insurance, which is included in every Massachusetts driver’s mandatory automobile coverage. PIP will provide a victim with up to $8,000 for medical expenses, lost wages and/or property damage. PIP coverage is subject to the deductible that the driver chose when he/she applied for his/her auto policy. So, for example, if a car accident victim chose a $500 deductible, then there would be a limitation of l $7,500 in coverage.
In addition to PIP coverage, if an accident victim’s reasonable medical expenses exceed $2,000, then they will be able to bring a claim against the other driver and their insurer. They also will be able to seek compensation for pain and suffering, mental anguish and reduced enjoyment of life that resulted from the accident. It is important to understand that only reasonable and necessary expenses will be included in the determination of whether the victim has incurred $2,000 worth of medical care. This means, for example, that if a victim chooses medications that their doctor considered optional, the costs of such medications might not be applied to the $2,000 threshold.
Whether or not a victim meets the injury threshold is typically a straightforward determination, since medical bills, property damage and lost wages are objectively measurable. This is not true of placing a value on pain and suffering and other noneconomic losses. The determination of those losses is far more subjective and may require expert medical testimony. To achieve the maximum recovery available, a victim should retain a skilled and experienced car accident attorney.
